妊娠妇女社会因素剖宫产状况及影响因素分析

Cesarean section due to social factors and its influencing factors in pregnant women

目的了解北京市海淀区社区人群社会因素剖宫产状况及其影响因素。方法2007年4-10月,对海淀区8所社区医院的1 126名接受产后保健的无妊娠合并症及并发症的海淀区户籍初产妇进行问卷调查并进行影响因素分析。结果55.6%初产妇为自然分娩,44.4%为剖宫产,其中,17.8%为社会因素剖宫产,占剖宫产的40.2%;社会因素剖宫产的主要原因为:确保孩子安全(35.9%)、身体差不能承受分娩(34.4%)、怕自然分娩失败再行剖宫产(15.6%)、难以忍受分娩痛(9.4%)等;Logistic回归分析,社会因素剖宫产的影响因素包括:产妇≥30岁、不了解分娩知识、亲朋同事多为剖宫产、孕期没有进行规律运动、孕期增重>16 kg、住院时未临产、医生的分娩建议不明确等。结论海淀区社会因素剖宫产率处于较高水平,社会因素剖宫产率受多种因素的影响。

Objective To investigate the status of cesarean section（CS） due to social factors and to discuss its influencing factors based on community population in Haidian district,Beijing.Methods Totally 1 126 puerperal women accepted postnatal care without pregnancy complications in eight community hospitals in Haidian district were evaluated with a questionnaire from Apr to Oct,2007.Results Of all subjects 55.6% were vaginal delivery,while 44.4% were CS and among them 40.2% were determined by social factors.The CS rate determined by social factors was 17.8%.The major reasons of cesarean section due to social factors involved ensuring the safety of newborn（35.9%）,being unable to tolerate the course of vaginal delivery（34.4%）,fearing of failure of vaginal delivery（15.6%）,and avoiding the pain of birth（9.4%）.The result of regression analysis for the vaginal delivery and social factors-induced CS cases showed that the independent affecting factors on cesarean section were the age of women≥30,insufficient acquaintance with the disadvantage of cesarean section,with relatives,friends or colleagues having CS,without regular exercises during pregnancy,pregnancy weight gain16kg,without labor onset at hospitalization,and without definite suggestion of delivery mode from obstetrician.Conclusion The rate of cesarean section due to social factors in Haidian district is high and is affected by multiple factors.